We explore race differences in how individuals experience mass incarceration, as well as in mass incarceration's impacts on measures of well-being that are recognized as major social determinants of health. We draw on baseline data from a sample of 302 men and women recently released from prison/jail or placed directly onto probation in New Haven, Connecticut (CT) for drug related offenses and followed at 6-month intervals for two years (2011-2014). We describe race differences in experiences of mass incarceration and in its impacts on well-being; and we conduct mediation analyses to analyze relationships among race, mass incarceration, and well-being. Blacks reported fewer adult convictions than whites, but an average of 2.5 more adult incarcerations. Blacks were more likely to have been incarcerated as a juvenile, spent time in a juvenile facility and in an adult facility as a juvenile, been on parole, and experienced multiple forms of surveillance. Whites were more likely to report being caught by the police doing something illegal but let go. Blacks were more likely to report any impact of incarceration on education, and dropping out of school, leaving a job, leaving their longest job, and becoming estranged from a family member due to incarceration. Whites were more likely to avoid getting needed health or social services for fear of arrest. Overall, Blacks reported a larger number of impacts of criminal justice involvement on well-being than whites. Number of adult incarcerations and of surveillance types, and being incarcerated as a juvenile, each mediated the relationship among race, mass incarceration, and well-being. Though more research is necessary, experiences of mass incarceration appear to vary by race and these differences, in turn, have implications for interventions aimed at addressing the impacts of mass incarceration on health and well-being.
This study used mixed methods to examine characteristics related to HIV testing among men who have sex with men (MSM) in Bogotá, Colombia. A sample of 890 MSM responded to a computerized quantitative survey. Follow-up qualitative data included 20 in-depth interviews with MSM and 12 key informant interviews. Hierarchical logistic set regression indicated that sequential sets of variables reflecting demographic characteristics, insurance coverage, risk appraisal, and social context each added to the explanation of HIV testing. Follow-up logistic regression showed that individuals who were older, had higher income, paid for their own insurance, had had a sexually transmitted infection, knew more people living with HIV, and had greater social support were more likely to have been tested for HIV at least once. Qualitative findings provided details of personal and structural barriers to testing, as well as interrelationships among these factors. Recommendations to increase HIV testing among Colombian MSM are offered.
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